The Scottish Medicines Consortium (SMC) has announced recently that abatacept (Orencia®) has been accepted for use within NHS Scotland, in combination with methotrexate (MTX), as a first-line biologic agent for adults with rheumatoid arthritis (RA), after failure with two conventional DMARDs. This recommendation enables the use of abatacept earlier in the treatment pathway providing physicians with greater treatment options and benefiting the patients who suffer from this disabling chronic disease. This advice published by the SMC will replace advice issued in September 2011.